Research

Research

“I think it is important that this Unit continues with more young new surgeons and an even more academic focus. Whilst the Government is very supportive, it cannot afford to give the extra finances needed for research and development, extra training and helping the occasional severely deformed child or children beyond our local jurisdiction. Giving to Jigsaw will allow this wonderful Unit to continue.” Dr. Tony Holmes

Research in the Department of Plastic Surgery

As the largest centre for cleft lip and palate surgery in Australia, we have a responsibility to continuing research. Considerable funding is required to support existing, as well as a number of future projects which are being set up.

In the last five years, we have obtained one of a few “cutting edge”, sophisticated three dimensional digital imaging systems in the world.

This will help patients by:

• Aiding doctors in pre-operative planning and post-operative assessment.

• For craniofacial patients, this has almost completely eliminated the need for post-operative computerised tomographic x-rays (CAT scans).

• Specifically, patients with infant craniosynostosis are all assessed pre-operatively and post-operatively using this technique and there is now a considerable database. Research has been able to show the post-operative shape, size and growth of the face and skull. It also allows us to calculate the increase of brain space within the skull without resorting to excessive anaesthetics or irradiation.

Objective, statistically significant data has been researched and the results presented recently at the International Meeting for Craniofacial Surgery in London (October 2009). These research programs will be continued and increased.

We’ve recently been awarded funding from the Royal Children’s Hospital Foundation, so we can set up the first three dimensional database of normal children’s measurements.

This hasn’t been done before and it requires more than 1500 children to be assessed. But once completed, this study will become a world benchmark against which children with craniofacial deformities can be assessed.

The Department is keen to set up a very accurate database of Cleft Lip and Palate abnormalities throughout its catchment area (Victoria, Tasmania and the Riverina).

• Having a large and detailed database leads to far more accurate research which will give a better indication of the cause of these deformities as well as improving the treatment outcomes.

• The Department would like to employ a genetic epidemiologist to do the research within this database and also to work in conjunction with molecular biologists doing genetic testing on the various tissues on children with deformities.

• This research would be in conjunction with the Murdoch Children’s Research Institute and would give our Department a chance of delineating the actual cause of this most common craniofacial affliction.

One of our aims is for our University and the Hospital to be the Australian Centre of Excellence for the management, treatment and research of Vascular Anomalies.

• Blood vessel and lymphatic malformations can often be the most distressing, dangerous and deforming problems in the spectrum of craniofacial surgery.

• The candidate for the academic Professorship which the Foundation is hoping to endow, is an expert at these vascular anomalies and already has impressive track record in this research.

A very important and long term research project that the Department is anxious to pursue is that of an Outcome Study.

How many of our patients end up happy with themselves, employed with successful careers and in successful relationships?

• While it’s possible for us to review and give our own assessment of the functional and aesthetic results of surgery on cleft and craniofacial patients, probably the most important long term outcome is the quality of the patient’s life and their perception of their place in society. After all, this is the aim of correcting craniofacial deformity in the first place.

• Around the world, there is a distinct lack of major outcome studies and an opportunity exists for Melbourne to lead the way in this type of research. Fortunately, Victorians tend not to migrate and therefore there is a good chance of a high success rate in locating long term patients.

• This work is particularly important in assessing in how well we are doing our job and what deficiencies may exist.

• It is also particularly important to show Health Departments and Governments how well their resources are being spent and may help to make a stronger case for further expenditure.